TY - JOUR
T1 - Pure Red Cell Aplasia in Major ABO-Mismatched Allogeneic Hematopoietic Stem Cell Transplantation Is Associated with Severe Pancytopenia
AU - Aung, Fleur M.
AU - Lichtiger, Benjamin
AU - Rondon, Gabriela
AU - Yin, C. Cameron
AU - Alousi, Amin
AU - Ahmed, Sairah
AU - Andersson, Borje S.
AU - Bashir, Qaiser
AU - Ciurea, Stefan O.
AU - Hosing, Chitra
AU - Jones, Roy
AU - Kebriaei, Partow
AU - Khouri, Issa
AU - Nieto, Yago
AU - Oran, Betul
AU - Parmar, Simrit
AU - Qazilbash, Muzaffar
AU - Shah, Nina
AU - Shpall, Elizabeth J.
AU - Champlin, Richard E.
AU - Popat, Uday
N1 - Funding Information:
The authors thank scientific editor Elizabeth Hess for her assistance in editing this manuscript. Financial disclosure statement: The authors have no financial disclosures. Conflict of interest statement: There are no conflicts of interest to report. Authorship statement: F.M.A. collected the data. F.M.A. and U.D. designed the study, analyzed and interpreted the data, and wrote the manuscript. G.R. provided the data. C.C.Y. reviewed and took the photomicrographs of the bone marrow biopsy slides. A.A., P.A., B.L., B.S.A., Q.B., S.O.C., C.H., R.J., P.K., Y.N., B.O., S.P., M.Q., N.S., I.K., E.J.S., and R.E.C. treated and monitored patients and reviewed the manuscript.
Publisher Copyright:
© 2016 American Society for Blood and Marrow Transplantation.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - In major ABO-mismatched allogeneic hematopoietic stem cell transplantation (HSCT) persistence of antidonor isohemagglutinins leads to pure red cell aplasia (PRCA). To investigate severe pancytopenia noted in a previous study of PRCA, we analyzed all major ABO-mismatched HSCT between January 2003 and December 2012. Of 83 PRCA patients, 13 (16%) had severe pancytopenia. Severe pancytopenia was defined as an absolute neutrophil count (ANC) < 1.5 K/μL or requiring granulocyte colony-stimulating factor, platelets < 50 K/μL or transfusion dependent, and PRCA with RBC transfusion dependence at post-transplant day 90. In 6 patients (46%) severe pancytopenia resolved after PRCA resolution. Two patients (15%) received a second transplant because of persistent pancytopenia/secondary graft failure, 1 (8%) died from secondary graft failure despite a stem cell boost, 1 (8%) did not recover his platelet counts despite RBC/ANC recovery, and 3 patients (23%) died from disease relapse. We found that severe pancytopenia is frequently associated with PRCA in 16% of major ABO-incompatible HSCT with a higher incidence in males and pancytopenia resolved with resolution of PRCA in 46% of patients.
AB - In major ABO-mismatched allogeneic hematopoietic stem cell transplantation (HSCT) persistence of antidonor isohemagglutinins leads to pure red cell aplasia (PRCA). To investigate severe pancytopenia noted in a previous study of PRCA, we analyzed all major ABO-mismatched HSCT between January 2003 and December 2012. Of 83 PRCA patients, 13 (16%) had severe pancytopenia. Severe pancytopenia was defined as an absolute neutrophil count (ANC) < 1.5 K/μL or requiring granulocyte colony-stimulating factor, platelets < 50 K/μL or transfusion dependent, and PRCA with RBC transfusion dependence at post-transplant day 90. In 6 patients (46%) severe pancytopenia resolved after PRCA resolution. Two patients (15%) received a second transplant because of persistent pancytopenia/secondary graft failure, 1 (8%) died from secondary graft failure despite a stem cell boost, 1 (8%) did not recover his platelet counts despite RBC/ANC recovery, and 3 patients (23%) died from disease relapse. We found that severe pancytopenia is frequently associated with PRCA in 16% of major ABO-incompatible HSCT with a higher incidence in males and pancytopenia resolved with resolution of PRCA in 46% of patients.
KW - Hematopoietic stem cell transplant
KW - Pancytopenia
KW - Pure red cell aplasia
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U2 - 10.1016/j.bbmt.2016.02.008
DO - 10.1016/j.bbmt.2016.02.008
M3 - Article
C2 - 26921820
AN - SCOPUS:84963692292
SN - 1083-8791
VL - 22
SP - 961
EP - 965
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 5
ER -